Organization
SOUTHERN TIER DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WINCHESTER LOGAN STUART DDS (PARTNER)
(716) 763-6823
Entity
Organization
Contact information
Practice address
133 E FAIRMOUNT AVE, LAKEWOOD, NY 14750-1950
(716) 763-6823
(716) 763-0341
Mailing address
133 E FAIRMOUNT AVE, LAKEWOOD, NY 14750-1950
(716) 763-6823
(716) 763-0341
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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